A short history of nearly everything - Bill Bryson [155]
Making a host unwell has certain benefits for the microbe. The symptoms of an illness often help to spread the disease. Vomiting, sneezing, and diarrhea are excellent methods of getting out of one host and into position for another. The most effective strategy of all is to enlist the help of a mobile third party. Infectious organisms love mosquitoes because the mosquito's sting delivers them directly to a bloodstream where they can get straight to work before the victim's defense mechanisms can figure out what's hit them. This is why so many grade-A diseases—malaria, yellow fever, dengue fever, encephalitis, and a hundred or so other less celebrated but often rapacious maladies—begin with a mosquito bite. It is a fortunate fluke for us that HIV, the AIDS agent, isn't among them—at least not yet. Any HIV the mosquito sucks up on its travels is dissolved by the mosquito's own metabolism. When the day comes that the virus mutates its way around this, we may be in real trouble.
It is a mistake, however, to consider the matter too carefully from the position of logic because microorganisms clearly are not calculating entities. They don't care what they do to you any more than you care what distress you cause when you slaughter them by the millions with a soapy shower or a swipe of deodorant. The only time your continuing well-being is of consequence to a pathogen is when it kills you too well. If they eliminate you before they can move on, then they may well die out themselves. This in fact sometimes happens. History, Jared Diamond notes, is full of diseases that “once caused terrifying epidemics and then disappeared as mysteriously as they had come.” He cites the robust but mercifully transient English sweating sickness, which raged from 1485 to 1552, killing tens of thousands as it went, before burning itself out. Too much efficiency is not a good thing for any infectious organism.
A great deal of sickness arises not because of what the organism has done to you but what your body is trying to do to the organism. In its quest to rid the body of pathogens, the immune system sometimes destroys cells or damages critical tissues, so often when you are unwell what you are feeling is not the pathogens but your own immune responses. Anyway, getting sick is a sensible response to infection. Sick people retire to their beds and thus are less of a threat to the wider community. Resting also frees more of the body's resources to attend to the infection.
Because there are so many things out there with the potential to hurt you, your body holds lots of different varieties of defensive white cells—some ten million types in all, each designed to identify and destroy a particular sort of invader. It would be impossibly inefficient to maintain ten million separate standing armies, so each variety of white cell keeps only a few scouts on active duty. When an infectious agent—what's known as an antigen—invades, relevant scouts identify the attacker and put out a call for reinforcements of the right type. While your body is manufacturing these forces, you are likely to feel wretched. The onset of recovery begins when the troops finally swing into action.
White cells are merciless and will hunt down and kill every last pathogen they can find. To avoid extinction, attackers have evolved two elemental strategies. Either they strike quickly and move on to a new host, as with common infectious illnesses like flu, or they disguise themselves so that the white cells fail to spot them, as with HIV, the virus responsible for AIDS, which can sit harmlessly and unnoticed in the nuclei of cells for years before springing into action.
One of the odder aspects of infection is that microbes that normally do no harm at